Provider Demographics
NPI:1447712732
Name:DOZIER, SHARITA L
Entity type:Individual
Prefix:
First Name:SHARITA
Middle Name:L
Last Name:DOZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2638 TWO NOTCH RD STE 108
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-1454
Mailing Address - Country:US
Mailing Address - Phone:803-779-7257
Mailing Address - Fax:
Practice Address - Street 1:2638 TWO NOTCH RD STE 108
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1454
Practice Address - Country:US
Practice Address - Phone:803-779-7257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily